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COVID-19: With no known vaccine for prevention, face masks to the rescue?

Since the coronavirus (COVID-19) was first reported in Wuhan, China in December 2019, it has spread to many parts of the world. On Feb. 27, Nigeria confirmed its first case of COVID-19.

Face masks
While scientists battle to find cure and vaccine for coronavirus, the readily available alternative is effective use of face masks

Ever since, the number of confirmed cases had continued to increase, fuelling fears of rapid spread as Nigeria has a large population of about 200 million people.

Though there is no vaccine yet for coronavirus, the World Health Organisation (WHO) said medical face masks should be worn by people who show symptoms of COVID-19, health workers and people who are taking care of people with COVID-19 in close settings (at home or in a health care facility).

On its part, the Nigeria Centre for Disease Control (NCDC) has issued new advisory to guide Nigerians on the use of face masks to check spread of COVID-19.

The Director-General of NCDC, Dr Chikwe Ihekweazu, said that globally, there was a debate on the effectiveness of masks as a preventive measure against COVID-19.

According to him, the use of masks can prevent an asymptomatic person (a person who never develops symptoms) from transmitting the disease as well as prevent transmission during pre-symptomatic period (before a person develops symptoms).

He added that there was emerging evidence of the ability of a mask to prevent contact with respiratory droplets.

The director-general said that comparisons also appeared to suggest better outcomes in countries that used masks as a general policy.

“Sources of concern have been that people who wear face masks may feel protected and ignore physical distancing advice.

“In addition, if face masks are not worn correctly, disposed of appropriately or if people touch their faces more frequently due to adjustments of face masks they are wearing, they run a higher risk of infection.”

He said that, in addition to face masks, the NCDC also recommended other measures such as physical distancing, hand washing and respiratory hygiene.

“Masks have to be properly disposed of in waste bins. Improper handling and frequently touching of masks can increase the risk of infection.

“Improvised masks are an option as long as they are properly washed regularly.

“They can be made out of cloth or other materials,” he said.

The director-general said that usage of face masks was particularly advisable when attending gatherings “where it is absolutely necessary to attend.”

He listed such gatherings to include shopping outlets, markets and pharmacies, among others, adding that patients and healthcare workers needed masks the most.

He advised that elderly persons with medical conditions such as diabetes should wear masks since they are at a higher risk of the infection.

He stressed that face masks should be used by those with respiratory problems and those already exhibiting COVID-19 symptoms and awaiting testing.

Ihekweazu said it was important to note that usage of face masks alone could not be relied upon to prevent COVID-19, stressing that physical distancing and regular hand washing were necessary for protection against the virus.

Ihekweazu advised that people should use fabrics coverings, not surgical masks or specialised N95 masks, which should be reserved for healthcare providers.

“If you are making your own covering, new research shows that some fabrics are better than others at filtering out viral particles.

“You have to use relatively high quality cloth,”  he said.

Ihekweazu noted that masks are not intended to protect wearers from getting sick, but rather, to prevent them from spreading the virus to others.

Dr Scott Segal, Chair of Anesthesiology at Wake Forest Baptist Health in Winston-Salem, North Carolina, carried out a study on the most suitable fabrics to use for face masks.

In partnership with Wake Forest Institute for Regenerative Medicine, he tested a variety of cloth materials to see which ones would not only allow for breathability, but also filter small particles such as viruses.

The research from Wake Forest has not been submitted for publication and has not been peer-reviewed.

To test various masks and fabrics, the team pumped air through both types of face coverings.

“Our instruments could read down to 0.3 microns, which is about the size of a big virus,” Segal said.

“Regular surgical masks filtered out 62 per cent to 65 per cent of particles, for comparison, N95 masks filter 95 per cent of those particles.

“But the fabrics led to a variety of results, one piece of cloth filtered just 1 per cent of particles, rendering it virtually useless, while others were found to perform even better than the surgical masks.

“We had some that performed at 79 per cent,” Segal told NBC News.

The best masks were constructed of two layers of heavyweight “quilters’ cotton” with a thread count of at least 180, and had thicker and tighter weave.

Lesser quality fabrics also worked well, as long as they had an internal layer of flannel.

“You do want to use woven fabrics like batik,” Segal said, “but you don’t want to use knit fabrics, because the holes between the knit stitches are bigger.”

In other words, if the fabrics allow for a substantial amount of light to shine through, it is probably going to allow tiny viral particles through, as well, Segal said.

Dr Osagie Ehanire, Minister of Health, advised Nigerians to always use dry masks.

“Make sure to use dry masks, when masks get wet, even from the moisture emitted when a person exhales, the fabrics could be more likely to transmit virus,” the minister said.

Ehanire stressed the need to wash masks regularly with detergent and in regular washing machine cycles. He said that Nigerians should avoid bleach or other harsher chemicals until they know the effect on the fabrics’ effectiveness.

Mr Boss Mustapha, Secretary to the Government of the Federation, and Chairman, Presidential Task Force on COVID-19, on his part, called on Nigerian tailors to start mass production of face masks, using the country’s local fabrics, to meet the increased demand.

He said that with face masks available, it would greatly reduce the spread of the coronavirus.

“It is critical to repeat, however, that compliance with the advisories for personal hygiene, social distancing, restriction of movement, early reporting of symptoms and wearing of masks regularly, especially in public, remain the best measures for the prevention of infections and to slow down the spread,” Mustapha said.

Meanwhile, many local manufacturers have risen to the challenge of producing masks as well as other items needed in checking the spread of COVID-19.

Gov. Okezie Ikpeazu of Abia said recently that local manufacturers in the state had mass-produced face masks that would end the importation of masks into the country.

Ikpeazu said that the state had sent the first batch sample of the product to NCDC for approval for nationwide distribution to ensure they meet appropriate health standards.

“They are medical items which you must sanitise in a specific way; we have used the recommended items to sanitise them and I hope it will meet the requirement of the NCDC,” he said.

The NCDC is already patronising locally made products. According to the NCDC, “everything we buy now in NCDC is from local manufacturers.”

While scientists battle to find cure and vaccine for coronavirus, the readily available alternative recommended by WHO, NCDC and other stakeholders is effective use of face masks, in addition to social distancing. Adherence to these recommendations, it is said, would check the spread of the virus.

By Racheal Abuja, News Agency of Nigeria (NAN)

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